Role of diet on non-alcoholic fatty liver disease: An updated narrative review

Abstract

The purpose of this article review is to update what is known about the role of diet on non-alcoholic fatty liver disease (NAFLD). NAFLD is the most common cause of chronic liver disease in the developed world and is considered to be a spectrum, ranging from fatty infiltration of the liver alone (steatosis), which may lead to fatty infiltration with inflammation known as non alcoholic steatohepatitis While the majority of individuals with risk factors like obesity and insulin resistance have steatosis, only few people may develop steatohepatitis. Current treatment relies on weight loss and exercise, although various insulin-sensitizing medications appear promising. Weight loss alone by dietary changes has been shown to lead to histological improvement in fatty liver making nutrition therapy to become a cornerstone of treatment for NAFLD. Supplementation of vitamin E, C and omega 3 fatty acids are under consideration with some conflicting data. Moreover, research has been showed that saturated fat, trans-fatty acid, carbohydrate, and simple sugars (fructose and sucrose) may play significant role in the intrahepatic fat accumulation. However, true associations with specific nutrients yet to be clarified.

Keywords: Diet; Non-alcoholic fatty acids; Fatty acids; Obesity; Insulin resistance

Core tip: The beneficial effects of weight loss and exercise have been well documented by many authors in reducing the steatosis, inflammation and fibrosis. Vitamin E can also be used with safety in adults only with biopsy proven non alcoholic steatohepatitis. Consumption of high fructose syrup to the development of non-alcoholic fatty liver disease is still under debate. The data for vitamin C shows no clear effect while the supplementation of n-3 fatty acids and probiotics is still conflicting but shows promise.